Healthcare Provider Details

I. General information

NPI: 1619491818
Provider Name (Legal Business Name): BRANDON JAMES BIGGS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2017
Last Update Date: 07/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 LOISDALE CT
SPRINGFIELD VA
22150-4908
US

IV. Provider business mailing address

250 S WHITING ST APT 1006
ALEXANDRIA VA
22304-3655
US

V. Phone/Fax

Practice location:
  • Phone: 703-359-7878
  • Fax:
Mailing address:
  • Phone: 816-255-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202215996
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: